Response to Long-term Vitamin D Therapy for Bone Disease in Children With Sickle Cell Disease

Williams, Kristen M.; Lee, Margaret T.; Brittenham, Gary M.; Fennoy, Ilene

doi:10.1097/mph.0000000000001155

Cited by 5 publications

(3 citation statements)

References 20 publications

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“…13 There is consistency across studies regarding the efficacy of vitamin D supplements in improving vitamin D nutrition of children with SCD. 5,17,[23][24][25][26][27][28] Vitamin D supplementation also reduced pain and improved quality of life, physical performance and bone health in this population. 17,[24][25][26][27]29 Our findings support the efficacy of a single bolus of 300 000 IU vitamin D 3 combined with daily 1 000 IU vitamin D 3 in raising 25(OH)D levels above 75 nmol/l in 83% of children with SCD after three months (vs. 45% for the placebo).…”

Section: Discussionmentioning

confidence: 91%

“…This RCT addressed the issues of low vitamin D intake, poor use of vitamin D supplementation and high prevalence of vitamin D deficiency previously reported in children with SCD 13 . There is consistency across studies regarding the efficacy of vitamin D supplements in improving vitamin D nutrition of children with SCD 5,17,23‐28 . Vitamin D supplementation also reduced pain and improved quality of life, physical performance and bone health in this population 17,24‐27,29 .…”

Section: Discussionmentioning

confidence: 97%

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Comparison of two vitamin D supplementation strategies in children with sickle cell disease: a randomized controlled trial

et al. 2020

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Previously, we showed that nearly 70% of children followed in our sickle cell disease (SCD) clinic were vitamin D-deficient and had low vitamin intake with poor use of supplements. We compared the change in serum 25-hydroxyvitamin D [25(OH)D], safety and clinical impact of two vitamin D supplementation regimens in children with SCD. Children (5-17 years, all genotypes) were randomized to a single bolus of vitamin D 3 (300 000 IU; n = 18) or placebo (n = 20). All children received a prescription for daily 1 000 IU vitamin D 3. Serum 25(OH)D and calcium, urinary calcium/creatinine ratio, musculoskeletal pain, quality of life, haematology and bone markers were assessed at baseline and three months post intervention. Bolus administration led to a greater rise in 25(OH)D levels from baseline compared to placebo (20 AE 16 nmol/l vs. 2 AE 19 nmol/l; P = 0Á003) and correction of vitamin D deficiency. No hypercalcaemia nor hypercalciuria occurred during the study, but more children in the bolus group experienced gastrointestinal symptoms within the first month (P = 0Á04). There were no differences between groups for other outcomes. The use of a high-dose vitamin D bolus combined with daily 1 000 IU vitamin D 3 was more efficient in raising 25(OH)D levels than daily supplementation alone in children with SCD.

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Section: Discussionmentioning

confidence: 91%

Section: Discussionmentioning

confidence: 97%

Comparison of two vitamin D supplementation strategies in children with sickle cell disease: a randomized controlled trial

et al. 2020

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“…A meta-analysis by Brustad et al concluded that high doses of vitamin D (daily doses to 10,000 IU/d or bolus doses to 600,000 IU) were safe with no increased risk of SAEs in young children aged 0 to 6 years [26]. Williams et al studied 4 SCD children with severe vitamin D deficiency, who received oral vitamin D 3 100,000 IU EOW for 8 weeks followed by monthly 100,000 IU for 22 months which improved vitamin D deficiency and BMD scores with no reported AEs [27]. Another study showed that monthly oral doses of vitamin D with 100,000 or 12,000 IU for 2 years improved respiratory disease rates > 50% in SCD children aged 3 − 20 years [28].…”

Section: Discussionmentioning

confidence: 99%

Safety and efficacy of monthly high-dose vitamin D3 supplementation in children and adolescents with sickle cell disease

Hanna,

Kamal,

Fawzy

et al. 2024

Eur J Pediatr

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Little is known about the impact of vitamin D supplementation on hand grip strength (HGS) and health-related quality of life (HRQoL) in children and adolescents with sickle cell disease (SCD). We aimed to evaluate the safety and efficacy of monthly high-dose vitamin D3 supplementation and its implications on bone mineral density (BMD), HGS, and HRQoL in patients with SCD and healthy controls. The study included 42 children with SCD and 42 healthy matched controls. The study participants were supplemented with high-dose monthly oral vitamin D3. Changes in the serum level of 25(OH) vitamin D3, maximum HGS, and BMD from baseline to 6 months were assessed, and the HRQoL questionnaire and Childhood Health Assessment Questionnaire (CHAQ) were used to evaluate the functional capacity. At baseline, SCD subjects had poorer growth status indicated by negative Z scores. Suboptimal BMD was detected by significantly lower Z score, and lower HGS and worse HRQL parameters were found compared to the controls (P < 0.001). Median 25(OH) vitamin D3 was significantly lower in SCD patients compared to controls (16.5 vs. 28 ng/mL, respectively (P < 0.001)). After 6 months of vitamin D supplementation, there was significant improvement in the DEXA Z-score (P < 0.001), limitation of physical health (P = 0.02), pain scores (P < 0.001), and CHAQ grades (P = 0.01) in SCD patients. A significant improvement in HGS (P < 0.001 and P = 0.005) as well as the CHAQ score (P < 0.001 and P = 0.003) was detected in the SCD group and controls, respectively. There were no reported clinical adverse events (AEs) or new concomitant medications (CMs) during the study duration, and safe levels of Ca and 25 (OH) D3 were observed at 3 and 6 months for both groups. There was a significant positive correlation between HGS and total physical score (r = 0.831, P < 0.001) and a negative correlation with CHAQ score (r = − 0.685, P < 0.001). We also detected a significant positive correlation between vitamin D levels at 6 months and HGS (r = 0.584, P < 0.001), pain score (r = 0.446, P < 0.001), and a negative correlation with CHAQ score (r = − 0.399, P < 0.001). Conclusion: Monthly oral high-dose vitamin D supplementation was safe and effective in improving vitamin D levels, HGS, and HRQoL in SCD children and healthy subjects, and BMD scores in SCD patients. Further randomized controlled trials are warranted to assess an optimal dosing strategy and to investigate the impact on clinically significant outcomes in children and adolescents with SCD and their healthy counterparts. Trial registration: ClinicalTrials.gov, identifier NCT06274203, date of registration: 23/02/2024, retrospectively registered. What is known:• Several studies have reported a high prevalence of vitamin D deficiency and suboptimal bone mineral density (BMD) in sickle cell disease (SCD) patients.• Musculoskeletal dysfunction is reported in SCD patients with a negative impact on physical activity and health-related quality of life (HRQL).• Little is known regarding the impact of vitamin D3 supplementation in children and adolescents with SCD. What is new:• We found that monthly oral high-dose vitamin D3 supplementation was safe, tolerated, and effective in improving serum vitamin D levels, HGS, BMD scores, and HRQL in SCD patients.

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Vitamin D supplementation for sickle cell disease

Soe

Abas

Than

et al. 2020

Cochrane Database of Systematic Reviews

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Response to Long-term Vitamin D Therapy for Bone Disease in Children With Sickle Cell Disease

Cited by 5 publications

References 20 publications

Comparison of two vitamin D supplementation strategies in children with sickle cell disease: a randomized controlled trial

Comparison of two vitamin D supplementation strategies in children with sickle cell disease: a randomized controlled trial

Safety and efficacy of monthly high-dose vitamin D3 supplementation in children and adolescents with sickle cell disease

Vitamin D supplementation for sickle cell disease

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